Effect of abdominal irradiation on growth in boys treated for a Wilms' tumor.
Affiliation
Department of Endocrinology, Christie Hospital, Manchester, England.Issue Date
1990
Metadata
Show full item recordAbstract
To study the effect of abdominal irradiation on spinal growth in childhood we have measured final height, sitting height, and leg length in 30 male survivors of a Wilms' tumor. Twenty-one patients received whole abdominal irradiation by either megavoltage therapy (MV: n = 11) or orthovoltage therapy (OV: n = 10); the remainder received flank irradiation. To examine the effect of the adolescent growth spurt on the irradiated spine we have followed prospectively seven patients who received whole abdominal irradiation and nine patients who received flank irradiation through puberty. Compared to a normal population there is a modest reduction in median final standing height SDS (H.SDS: -1.15) accompanied by a marked reduction in median final sitting height SDS (S.HT SDS: -2.41) with no apparent effect on median subischial leg length SDS (SILL.SDS: 0.04). This reduction in spinal growth is reflected by a strongly positive disproportion score (DPS; [SILL SDS-S.HT SDS] + 2.81). The incidence of scoliosis after abdominal irradiation has been low (10%). During puberty there is a significant fall in median sitting height SDS after both whole abdominal (median fall: -0.9, P = 0.02) and flank irradiation (median fall: -1.85, P = 0.01), and this is reflected in a significant increase in disproportion (DPS: whole abdominal; median rise +1.4, P = 0.02: flank, median rise +1.34, P = 0.01). After MV irradiation there is a significant correlation between the degree of disproportion and the age at treatment (P less than 0.0005). The younger the patient is at treatment the more severe is the restriction on spinal growth and the shorter and more disproportionate they become as an adult. The estimated eventual loss in potential height from abdominal irradiation at the age of one is 10 cm and at five years is 7 cm.Citation
Effect of abdominal irradiation on growth in boys treated for a Wilms' tumor. 1990, 18 (6):441-6 Med. Pediatr OncolJournal
Medical and Pediatric OncologyDOI
10.1002/mpo.2950180602PubMed ID
2172754Type
ArticleLanguage
enISSN
0098-1532ae974a485f413a2113503eed53cd6c53
10.1002/mpo.2950180602
Scopus Count
Collections
Related articles
- Final height and IGF1 in adult survivors of Wilms tumour.
- Authors: Blijdorp K, van den Heuvel-Eibrink MM, Pieters R, Pluijm SM, Wagner A, Segers H, van der Lely AJ, Neggers SJ
- Issue date: 2013 Oct
- Effect of spinal irradiation on growth.
- Authors: Shalet SM, Gibson B, Swindell R, Pearson D
- Issue date: 1987 May
- The evolution of spinal growth after irradiation.
- Authors: Clayton PE, Shalet SM
- Issue date: 1991 Jul
- Skeletal effects of megavoltage irradiation in survivors of Wilms' tumor.
- Authors: Heaston DK, Libshitz HI, Chan RC
- Issue date: 1979 Sep
- Skeletal alterations following irradiation for Wilms' tumor: with particular reference to scoliosis and kyphosis.
- Authors: Riseborough EJ, Grabias SL, Burton RI, Jaffe N
- Issue date: 1976 Jun